Prevention of dental caries Flashcards
what is the impact of caries on preschool children
aesthetic problems
loss of function
pain
infection
why is it easy for an abscess to spread in younger children
bone is softer
what is the distribution of caries in the population
skewed
25% of scottish chidden have 75% of disease
what are risk indicators in children
Oral hygiene Diet Bacterial exposure Socioeconomic status Breast/bottle feeding Fluoride exposure Parental smoking Parental oral health status
what is early childhood caries also known as
nursing caries
what is the typical cause of nursing caries
inappropriate use of feeding cups and bottles
what teeth does nursing caries generally affect
upper anterior and molar teeth
should women be advised to take fluoride supplements during pregnancy
no - there is no benefit to the child taking fluoride supplements during pregnancy
when should a child be taken off breast feeding
1 year
when should we stop on demand feeding
6 months
why is breast milk beneficial
has maternal antibodies
when should a feeding cup rather than a bottle be recommended
6 months
what type of spout should bottles have
free flow spout
why should soya milk not be recommended
cariogenic
if there is suspicion of the use of sweetened drink what is the advice
restrict to meal times only
dilute
drink through a straw
where should the straw be placed
at the back of the mouth, on top of the tongue and not touching the anterior teeth
what is the main dietary advice
restrict sugary food and drink to meal times onlye
encourage use of non sugar sweeteners
encourage sugar free chewing gum
prescribe sugar free medicine
what are the safe drinks between meal times
water
milk
what are the safe snacks
milk/water fruit savory sandwiches crackers and cheese bread sticks crisps
how can we analyse diet
diet diary
how can fluoride be delivered
water
tooth paste
supplementary self delivered
professionally delivered
what are the supplementary self delivered fluoride possibilities
drops
tablets
mouth rinse
what are the different ways fluoride can be professionally delivered
APF gels
varnishes
slow release devices
what percentage of the UK receives fluoridated water
7
what is the optimum level of water fluoridation
1.0 ppm
when should we start toothbrushing
as soon as first primary teeth erupt
under what age to children lack the dexterity to brush their own teeth effectively
8
when should young children have their teeth brushed
by an adult before bed and at one other time in the day
what is the fluoride ppm in child formulations
1000 ppm
what is the fluoride ppm in standard fluoride toothpaste
1400-1500 ppm
what is the ppm in enhanced fluoride toothpaste e.g durapahat
2800 ppm
what is the fluoride strength recommendation for standard risk kids up to 3 years old
1000
what is the fluoride strength reccomendation in children 4-16 years standard risk
1000-1500ppm
what is the fluoride risk recommendation in high risk children under 10 years
1500 ppm
what is the fluoride risk recommendation in high risk children 10 and over
2800 ppm - prescription only
what is the fluoride concentration in high risk 16 years old and over
5000ppm
what is the amount of tooth paste in children under 3
a smear - 0.1ml
what is the amount of tooth paste for children aged 3 and over
a pea sized amount - approx 0.25 ml
what do we need to know when assessing whether the fluoride ingested is enough to be toxic
weight of child
amount of paste swallowed
how much mg of fluoride in a 90 g tube of 1000ppm toothpaste
90 mg
what is the amount of toothpaste ingested tp receive a probably toxic dose
5mg/kg
how do you manage fluoride toxicity if under 5mg/kg is ingested
give calcium orally (milk) and observe for a few hours
how do you manage fluoride toxicity if 5-15 mg/kg is taken
give calcium orally (milk, calcium gluconate, calcium lactate) and admit to hospital
how do you manage fluoride toxicity if greater than 15mg/kg is ingested
admit to hospital immediately, cardiac monitoring and life support as well as intravenous calcium gluconate.
why do we not induce vomiting anymore
risk of aspiration of vomitus.
From what age can fluoride mouthwash be given
over 6 years of age - must assess child’s ability to properly expectorate
how often should a fluoride varnish be placed
at least twice yearly for preschool children at increased risk of caries
high risk adults as well
what is health education
Health education is a process that results in individuals or groups having increased knowledge related to health.
what is healthy promotion
supports individuals in translating their health knowledge into positive behaviors and lifestyles.
when do we start oral health promotion in children
from 3 years of age
what should we do for diagnosis
clinical exam
bitewing radiographs
what are the other ways to diagnose
o Fiberoptic transillumination o Temporary tooth separation o Air abrasion o Co2 laser o Electric caries meter
how often do we take bitewings for high risk children
6 months
how often do we take bitewings for low risk
12-18 months
